Newsletter

ARTICLE: Improve Population Health Analytics with the ACG® System

Wed, 22 Apr 2015

For more than 30 years, the ACG System has become the global standard for risk adjustment. Currently licensed and used in 16 countries across the world, the ACG System is based on the guiding principle that clustering of morbidity is a better way to predict how health services will be used. As a result, billions of dollars per year are now exchanged using the ACG System, while the health care of millions of patients is managed and monitored using the system.

With the release of Version 11, the Johns Hopkins ACG® System boasts improvements to its predictive accuracy for identifying high-risk members of a given population, and provides robust clinical categorization to assess and stratify populations. Version 11 includes several new and refined models as well as upgraded risk assessment variables.

New Models:

A readmission risk model to identify the likelihood of an individual experiencing an unplanned readmission within 30 days of discharge from an inpatient facility;

A persistent high-user model to predict the probability that an individual will be in the top 20% of users in the population for four consecutive half-year periods;

A regression-based concurrent risk score, provided in addition to the concurrent scores derived by relative cost within ACG categories.

Refined Models:

A logistical regression to predict the likelihood of an individual costing in the 95th percentile or higher;

Revision to the all-age reference population. This adjustment will weight pediatric, adult and elderly patients differently.

Improved Risk Assessment Variables:

Several new classification variable for patients, including those for receiving psychotherapy, utilizing mechanical ventilation and diagnoses classified by the United States Social Security Administration under compassionate care allowances;

Detail of the frailty conditions a patient has experienced;

Care density metrics or measure of patient sharing among providers.

In addition to these updates and refinements, Version 11 better accommodates and handles new ICD codes that can indicate more than one disease. As a result, the ACG System makes it possible for a single code to trigger multiple ADG and EDC categories. Along with these changes, Version 11 also contains several reporting enhancements: